Background
Sleep disturbances in alcohol-dependent (AD) individuals may persist despite abstinence from alcohol and can influence the course of disorder. Although the mechanisms for their sleep disturbances are not well understood and some evidence suggests dysregulation of circadian rhythms, dim-light melatonin onset (DLMO) has not previously been assessed in AD vs. healthy control (HC) individuals in a sample that varied by sex and race.
Methods
Fifty-two AD participants (mean age 36.0 ± 11.0 years, 10 women) who were 3–12 weeks since their last drink (mean abstinence 57.9 ± 19.3 days) and 19 age- and sex-matched HCs (mean age 34.4 ± 10.6 years, 5 women) participated. Following a 23:00 – 06:00 h at-home sleep schedule for at least 5 days, and screening/baseline nights in the sleep laboratory, participants underwent a 3-hr extension of wakefulness (02:00 h bedtime) during which salivary melatonin samples were collected every 30 minutes beginning at 19:30 h. The time of DLMO was the primary measure of circadian physiology and was assessed with two commonly used methodologies.
Results
There was a slower rate of rise and a lower maximal amplitude in the AD group. DLMO varied by methodology used. Using 3 pg/ml as a threshold, no significant differences between the AD and HC groups were found. Using two standard deviations above the mean of the first 3 samples, AD DLMO occurred later 21:02 (SD=0:41) than HC 20:44 (SD=0:21) t=-2.4, (p=.02).
Conclusions
While melatonin in the AD group appears to have a slower rate of rise, using well-established criteria to assess salivary DLMO did not reveal differences between AD and HC participants. Only when capturing melatonin when it is already rising was DLMO significantly delayed by a mean 18 min in ADs. Future circadian analyses on alcoholics should account for these methodological caveats